Cystoscopy to remove an intrauterine contraceptive device embedded in the urinary bladder wall: a case report and literature review

Qu, Rui; Luo, Yan; Dai, Yi

doi:10.1177/03000605211015032

Cited by 5 publications

(7 citation statements)

References 7 publications

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“…Occasionally, perforation can be spontaneous (secondary) which occurs at a later time, after insertion, likely due to chronic inflammatory process or spontaneous uterine contractions. 11,13,15 We believe that our patient had a spontaneous uterine perforation and subsequent intravesical migration as she did not have any immediate complication after the IUD insertion. Spontaneous uterine perforation is very rare, with an incidence of 0.12-0.68/1000 insertions.…”

Section: Discussionmentioning

confidence: 71%

“…LUTS are the commonest manifestations, and a recurrent UTI is the usual initial diagnosis. 11 , 13 , 14 Local mucosal irritation by the copper IUD, proliferation of bacteria, and organization of calculi over the foreign body nidus are responsible for the symptoms. 14 Many patients including our case visit multiple physicians looking for a cure without realizing that the primary problem is with the incomplete diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Cystoscopy-guided removal is often employed in a complete intravesical migration of IUD. 8 , 11 An encrusted device might require additional fragmentation procedure. Laparoscopic or open surgical removal can also be used in difficult cases.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] IUD is a well-known and preferred method of contraception in the developing world. 11,12 It is easily inserted, has a reversible effect, has a high success rate, and causes few side effects. The common IUD types currently in use are the copper-releasing IUD (TCu-380A) and the Levonorgestrel-releasing IUD (LNG-IUD).…”

Section: Discussionmentioning

confidence: 99%

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Gross Hematuria Caused by Intravesical Migration of a Forgotten Intrauterine Device: A Case Report and Literature Review

Salih¹,

Tefera²,

Gebrehiwot³

et al. 2022

RRU

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Intrauterine device (IUD) is the second most widely used method of contraception worldwide. Up to 14% women prefer IUD for its attractive advantages such as cost effectiveness, high efficiency, and low complication rate. Despite these advantages, however, some complications may occur. One of these complications is uterine perforation and migration of the device to involve adjacent viscera such as peritoneum, bowel, vessels, and rarely bladder. IUD migration into the urinary bladder is uncommon, and only 70 cases are reported in the literature. Recurrent urinary tract infection and bladder calculi are the commonest presentations, and, rarely, women can present with gross hematuria. A high index of suspicion is needed in the evaluation of women who report pregnancy after IUD insertion as it might be the first clue to suspect migration. A forgotten and long-standing IUD increases the risk of uterine perforation and migration. A routine abdominal radiography, cystoscopy, and transvaginal ultrasonography are diagnostic. A computed tomography can also be employed in selected cases to delineate anatomic relations. Urologists should consider a vesical foreign body such as migrated IUD in women with recurrent lower urinary infections. Gross hematuria in a young woman should alert the urologist, and the evaluation should address a detailed contraceptive history. Every migrated IUD should be removed via endoscopy, laparoscopy, or open surgery. Proper follow-up and education of women before and after IUD insertion is also recommended to pick up on complications in time. Here, we report the successful open surgical treatment of a woman who had a forgotten IUD for 15 years and ultimately presented with gross hematuria due to trans-vesical migration. As to our literature search, there was no similar case reported from a urology center from Ethiopia.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Gross Hematuria Caused by Intravesical Migration of a Forgotten Intrauterine Device: A Case Report and Literature Review

Salih¹,

Tefera²,

Gebrehiwot³

et al. 2022

RRU

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“…4,21 Secondary perforation can occur later, likely due to chronic inflammation or spontaneous uterine contractions. 7,22,23 One case (no. 7) in our study showed secondary perforation.…”

Section: Author Contributionsmentioning

confidence: 99%

Complete perforated bladder from intrauterine devices: A case series report from a nationwide monitoring system

Zhang

Sun

Yang

et al. 2023

J of Obstet and Gynaecol

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Complete perforation of the bladder caused by an intrauterine device (IUD) is rare. This study examined the characteristics of patients associated with IUDrelated bladder perforation and evaluated the relationship between mislocated IUDs and their potential complications. Methods: From October 2005 to December 2021, 13 reports regarding complete perforations to the bladder by IUDs were retrieved from the National Contraceptives Adverse Reaction Monitoring System of China. The clinical features of these cases were analyzed. Results: The median patient age was 30 (range, 27-46) years. There were four cases (4/13, 30.8%) with IUDs placed during lactation, one case (1/13, 7.7%) with an IUD placed after medical abortion, and eight cases (8/13, 61.5%) placed after menstruation. Seven cases (7/13, 53.9%) were first-time IUD users. The median duration of IUD placement was 47 (range, 1-145) months. Unexpected pregnancy was reported in five cases (5/13, 38.5%). Six cases (6/13, 46.2%) reported bladder stones with varying degrees of abdominal pain or urinary tract infection. Removal methods included laparotomy (four cases), cystoscopy (four cases), laparoscopy (two cases), laparoscopy combined with cystoscopy (two cases), and laparotomy after cystoscopy (one case). All IUDs were successfully removed. Conclusions: Complete perforation to the bladder by IUDs is a rare adverse event. Regular follow-up is required after the placement of IUDs. The possibility of uterine perforation should be investigated if IUD users encounter persistent lower abdominal pain or urinary tract infection.

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Intrauterine Contraceptive Device Migrated in the Urinary Tract: Case Report and Extensive Literature Review

Varlas,

Meianu,

Rădoi

et al. 2024

JCM

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The migration or translocation of an intrauterine device (IUD) in the urinary tract is a rare event. Here, we present the case of a 55-year-old woman who accidentally discovered the ectopic presence of an IUD following a radiological examination for pelvic pain caused by a lumbar discopathy. Over the years, the patient had several IUDs inserted without being able to specify which one had migrated. The removal of the IUD was performed laparoscopically with the minimum resection of the bladder wall and the subsequent cystorrhaphy. The evolution of the patient was favorable. To better analyze these events, we conducted an all-time extensive electronic search of the PubMed database and identified 94 eligible articles, with a total of 115 cases. The literature analysis on the IUD migrations shows either the simultaneous existence of the second IUD or of a maximum number of up to two IUD insertions during the life of patients. Thus, in the presented case, we identified five IUD insertions over time, which explained the chronic inflammatory process by forming an important mass of adherents that included the urinary bladder, uterus, omentum, sigmoid colon, and abdominal wall. Therapeutic management must be adapted to each case depending on the intra/extravesical location of the migrated IUD evaluated by imaging.

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Cystoscopy to remove an intrauterine contraceptive device embedded in the urinary bladder wall: a case report and literature review

Cited by 5 publications

References 7 publications

Gross Hematuria Caused by Intravesical Migration of a Forgotten Intrauterine Device: A Case Report and Literature Review

Gross Hematuria Caused by Intravesical Migration of a Forgotten Intrauterine Device: A Case Report and Literature Review

Complete perforated bladder from intrauterine devices: A case series report from a nationwide monitoring system

Intrauterine Contraceptive Device Migrated in the Urinary Tract: Case Report and Extensive Literature Review

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